Building our family through IVF

IVF #2: Decision-Making Standstill

We met with our RE on Friday for blood work and an ultrasound. As he was speaking with us, he mentioned our PGS results and said, “Now you guys just have to decide which embryo you want to transfer.”

“Just one?” I clarified.

He launched into an explanation of higher risks associated with multiples, and how if it were his kid and his choice, he’d choose just one. He added that at my age (31) I’m likely to bounce back from a singleton pregnancy, but twins would do a number on my body. “You don’t want all that saggy skin,” he harped.

No, I don’t want saggy skin. Most of all, I don’t want to put my babies at risk. I don’t want to put myself at risk, either. What do I want? To be pregnant. To deliver happy, healthy, baby(ies).

This advice from our RE is a little unexpected. When we interviewed Dr. W, we loved that he said we could transfer two embryos, and we would. Why the change of tune? I didn’t ask, because I was in too much shock. Is it because we did PGS and filtered out the ones he knew wouldn’t stick? I’m so confused, and frankly disappointed.

Last time we transferred one embryo, because it was all we had. In return, we got nothing but a negative beta, devastation, and complete heartache. I really liked the security of transferring two this time. In my mind, it sets us up for a greater chance of success. I wonder how much more we have the ability to endure. Are we strong enough to go through that pain again? I am afraid it might break me.

Then I think it through and realize, the thing that would break me more is to feel like I made the wrong choice. Heaven forbid we choose to transfer two embryos, and that decision is at the cost of the health or lives of our babies. Damn you, infertility. Fertile couples don’t have to make decisions like this.

Chris and I have talked circles around what to do, and what the best decision will be for us and for our family. All we’ve concluded is that this is a more difficult conversation than we realized it would be. To be honest, we are pretty stressed about making the right choice, and that has resulted in us treating each other less than our best. I love that we’re aware of this, and we’re doing everything in our power to turn it around, work together, and get on the same page. We know we’ll figure this out together. Eventually. 😉

30 thoughts on “IVF #2: Decision-Making Standstill”

Such a hard place to be! I’ve been there too and it’s not easy. We made the decision to transfer two with our last pregnancy as we only had two frozen embies left and we knew they were graded differently. The chances of both of them sticking was probably low. But given we’re 500km away from our centre and the costs associated, not just with the treatment but also the travel, we decided to take the risk.
The fact that you’re both talking about it is a great thing and you will end up making the right decision for you right now. Does knowing that make it any easier, no probably not! But trust in each other – I suspect, from what I know of you reading your blog, you’re both a lot stronger than you think xx

Lol saggy skin is such a strange reason for a doctor to use – does he think you’re that vain?! I’m personally on the singleton boat, BUT if my 3rd IVF hadn’t worked I would have tried two embryos. In my province they don’t allow more than one unless you’ve had several BFN transfers already anyway, because they’re looking to reduce the risk of too many multiples via IVF. Even simulated IUIs, they will cancel a cycle if there are 4 or more follicles at trigger time. If I had two excellent grade embies, I’d do only 1 at a time. I only ever had 1 excellent embryo out of… 49 eggs though.

Hard place to be in. Here in Australia its standard to only transfer one embryo unless you have four or more failed transfers- and I would think with a PGS normal embryo, they would go back to a single transfer. IUI is cancelled if there are more then 2 dominant follicles as well. Maybe they play it a bit safer here?
Good luck with your decision, and hopefully you and your partner arrive at a decision that is the right one for both of you

what a difficult decision! We’ve been told since the start that unless the embryos are of varying quality (i.e. the risk that one won’t implant is higher), or you are over 40 years old, they won’t transfer more than one back in. I guess that makes sense – as you said the aim is for the mum to be as healthy as possible, and the risks with twins have been proven… although lots of people do have twins successfully (and without the overly baggy skin!). I don’t know if they told you this, but our consultant said that the chance of identical twins (I.e. the embryo splitting) is much higher in IVF than it is with natural pregnancy – my friend had one embryo transferred last year and now has two beautiful girls… so there is always a chance for twins! Good luck with your decision making 🙂

Thank you. Yes, our embryos are varying quality, but our RE said they’re all pretty good. I didn’t know about the increased chance of identical twins. That’s really good to know. Thank you for the info, my dear!

This was such a tough call for us too. We knew the risks associated with twins, but wanted to bring home a baby so badly, it didn’t really matter that much to us for transfer 2 and transfer 3. Plus, there are plenty of people who get through twin pregnancies just fine right??? I really wanted to be one of them.

Well, I am not one of those people apparently. My body did not handle twins well, and I miscarried genetically healthy embryos both times. Something I never knew but learned once pregnant with twins was if one twin vanishes, the chances of the singleton left behind being as healthy as it would have been alone are much lower. There are some studies out about this. All this being said, from here on out we will do only 1 at a time.

I think the fact that your RE wants to transfer just one shows he has confidence in your embies and it working! Im not so sure the flabby skin was a great way for him to get his point across though lol. This flabbiness can just as easily happen with 1! By the way, my cousin had IVF twins and she looks amazing at almost 35.

Again, this is totally a tough decision & I am positive u two will make the decision best for you all (even if it takes working through a few spats 😛). I just wanted to share our experiences with you. Thinking of u & praying you can make your decision soon…Baby dust, my friend!!! ❤️🙏🏽

Thanks, Angela. It’s good to keep this all in perspective. Thanks for sharing your background in relation to twin transfer, as well as your cousins. Hope school is going well, my friend. We start this week, and I’m so excited!

It is definitely a tough decision. My RE told me that he recommended a single embryo transfer to limit the risk of high order multiples if one or more of the embryos split. For us, we ultimately only had one good embryo to transfer anyway. But it turns out that that embryo split and now I am pregnant with identical twins. My clinic says that the risk of an embryo splitting is about 2%, but procedures like ICSI, assisted hatching, and PGD can increase that risk. Just something to keep in mind when trying to make your decision.

My RE is the same way. They are wanting to reduce the number of multiples to increase your chance of a healthy baby. It’s still a hard pill to swallow, especially if you’ve been thinking about twins and getting excited for your lives as a family with multiples. If you’re anything like me and thinking about the possibility of twins, you may have already imagined how you would decorate the room, the clothes you would buy and all the equipment you would need for twins; so, naturally, it’s quite the shock and disappointment to hear “just one.”

Arguments are bound to occur, but it sounds like you guys are working through it. Nothing about infertility is easy, but I hope that your marriage comes out stronger as a result of this.

Amanda–yes, I think the tough part is we’ve been envisioning life with two bouncing babies, and now we’re readjusting that perspective. We definitely can handle a little heated discussion now and then, but you’re right. Infertility is not easy. I know we’ll be stronger in the end, I just need to keep reminding myself of that.

If my RE mentioned “saggy skin” I’d backhand him and go elsewhere. I get the multiples part, and in Europe I’ve heard single embryo transfers are standard practice. (I’m 41, doing donor egg IVF in a few weeks, and we are only transferring one embryo).

Hahaha–yes, I couldn’t believe he said that. I hate to look past stupid comments, but he’s lightyears better than our previous RE, so we’re going to stick it out. Good luck with your IVF cycle! We’re cheering for you.

Now this is a very interesting subject and I can see it equally from both sides of the argument. In our first round we were advised to have 2 embies transferrred. At the time i didn’t realise our result were that bad they didn’t expect either of the embies to survive, but against the odds we had one precious son from that round. Looking back we made the right decision to have two transferred. I still feel effected by the loss of one embie, something you can relate to, but having one child for us, healed that heavy heart. Then fast forward to round 2, we had some good results (still not as amazing as yours) we went in thinking we’d go for two again, but the embryologist turned to me and said at your age (29) do you want to end up with twins? (Don’t get me wrong, twins are amazing) I assessed everything, how if we did have twins we need a bigger car etc, how both babies might have the same medical condition as my son, and if I would physically be able to cope with two babies, the way my body would be effected, and also the way I felt from my first cycle, and having one precious baby survive and loosing the other, what if both didn’t make it, what if one did, what if both did. We had one transferrred on our second cycle and conceived! You have good results, you’re young, which goes in your favour, above everything do what you feel in your heart is the right decision for both of you. Your journey is your journey, no one else’s and no one can’t understand how you two have personally felt. My cousin just had twins girls. She loves them to bits. She says it’s hard, but even with the saggy skin she was born to be a twin mommy. Xx

You’ve been talking about two for a while now, it sounds like the doctor hasn’t given YOU a specific reason not to transfer two and sounds a bit like a generic spiel. But if he says it’s because of the PGD then I’m annoyed for you that he didn’t tell you this when you decided to do it. Either way my dear, I hope your path becomes clearer for you both v soon.

How strange. We got a bait and switch, too and I remember feeling very powerless. Part of me wanted to argue and ask why our RE had said one thing previously and was now saying something else, and essentially guilting me into SET. But the other part of me didn’t want to argue – we knew at that point we’d be working with the clinic for a long time and bad blood didn’t seem worth it, plus my confidence in transferring two was shaken. Anyway, all to say I understand how you felt and the merry go round of decision making.

I am under 35 as well, so my clinic made me sign something saying they would only transfer 1 embryo at a time. It is in response to ASRM guidelines (link below). We can thank Octomom for these guidelines…

I would say to talk to the Dr. about the change. When I did it I was 32 and she told me that the chances of pregnancy with the transfer of one would be 37% but to transfer two embryos would result in a 63% chance of pregnancy and a 51% chance of twins. We made the decision of two and it resulted in a single pregnancy. I know it’s hard, but whatever decision you make will be fine.

Our RE had the same spill about multiples with us and it really frustrated me because it put so many worries in my head that I never had before. I wanted to know why others were able to do two and if they got the same lecture? Go with your heart and that will be the right decision. There so many “what ifs” and those thoughts are the last thing you need right now. Sending prayers your way!

I transferred 2 PGS normal embryos and only one stuck, which validated our decision-making. But, I was 35 which is a world of difference from 31.

Having said that, we will have to make the same decision with baby #2 someday. I can tell you from personal experience with this pregnancy that I have no intention of carrying twins ever. Once you go through some complications with a singleton you start to appreciate how much worse it would be with twins. I don’t want to put my body through hell – I think one healthy baby should really be the goal.